Fundamentals of Nursing Q 320

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The nurse is assessing a client who states her last menstrual period was March 17, and she has missed one period. She reports episodes of nausea and vomiting. Pregnancy is confirmed by a urine test. What will the nurse calculate as the estimated date of delivery (EDD)?

  

     A. November 8

     B. May 15

     C. February 21

     D. December 24

    

    

Correct Answer: D. December 24

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Naegele’s rule: add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery. Naegele’s rule, derived from a German obstetrician, subtracts 3 months and adds 7 days to calculate the estimated due date (EDD). It is prudent for the obstetrician to get a detailed menstrual history, including duration, flow, previous menstrual periods, and hormonal contraceptives.

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Option A: Determining gestational age is one of the most critical aspects of providing quality prenatal care. Knowing the gestational age allows the obstetrician to provide care to the mother without compromising maternal or fetal status. It allows for the correct timing of management, such as administering steroids for fetal lung maturity, starting ASA therapy with a history of pre-eclampsia in previous pregnancies, starting hydroxyprogesterone caproate (Makena) for previous preterm deliveries.

Option B: An average pregnancy lasts 280 days from the first day of the last menstrual period (LMP) or 266 days after conception. Historically, an accurate LMP is the best estimator to determine the due date.

Option C: An official EDD is established after calculating the first-trimester sonogram EDD date and then using the LMP. If the LMP and first trimester EDD are within 7 days of each other, the LMP estimates the due date. The margin of error is reduced depending on when (i.e., how early) the sonogram occurred.

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